HomeMy WebLinkAboutPermit Building 1994-9-9
RESIDENTIAL
PERMIT APPLICATION
Ins pect! ons:726-3769
Office: 726.3759 .
SPRINGFIELD
LOCATION OF PR0POSED WORK: ~ 2~1
~SSESSORS MAP' t?{)~(}::\M
LOT'
c:::;- 0 ..
Cci S L..?( ~
BLOCK:
OWNER:3~ \~ '\\ e. '12\ LL.
ADDRESS:' 525"' (2. ~.. ~ cc... ~
"3~
I ~
CITY:
....5~ <QQ~_
~ i-
STAT 1=. ()VE:.9 ClV\
DESCRIBE WORK:
'NEW Y REMODEL
~~. ~ l)tldoftrtL
.-
CONST.
CONTRACTQR'S NAME., ' ADDRESS'. CONTRACTOR #
-rlrJz( (( bto~5 ~L-S- /'.r:..stl/t.ci L/h20 I
.PLUMBING: .tJ.LI4rfl)FGzs~ ?~6(. ~
..J
MECHANICAL: A:-Llk1A. F~ </L-A I'.o~ '10 I YU: J<rt.-.,:''d,
ELECTRICAL: L'-Otv\ h. {/V\- ~c.. -f-
GENERAl.
t
QUAD AREA:
# OF BLDGS:
L\R~~
~. .
\~~~ ~
'~ .
{;?
'--"
OCCY GROUP:
......
-t..r# OF STORIES:
" ..
\
\VATER HEATER:
......./.,,"
J .
rvl 'foundation - After forms are
L.f)Verected but prlortoconcrete
/ placement.
,//
D Underground Plumbing - Prior
to filling trench.
1Vl. Underfloor Plumbing/Mechanical
L....fW - Prior to Insulation or decking.
rvl Post and Beam - Prior to floor
L..f"J Insulation or decking,
r\11 Floor Insulation - Prior to
LfJ decking,
r\7l Sanitary Sewer - Prior to filling
L.f"J trench.
f\7I Storm Sewer - Prior to filling
( trench. .
,
r\7l Water Line - Prior to filling"
T trench. ". .'
"rv::J ~R~ugh Pluinblng -:'::-Pi'lorto
L-f>J cover. .
ADDITION
, DEMOLlS~
OTHER
;OB NUMBER 7,4/0 L;~
225 Fi fth Street
Springfield, Oregon 9
Si~ ~, C)V-C'-5' ~
TAX LOT:. . n~IIOU~1//
SUBDIVISION: F:~+o-v\
PHONE:
~
? Zr;. I 57 C/
ZIP:
97'f7 ~
EXPIRES
c:; h 26 l
{
PHONE
/
l-k~ ~ ~c
\
- OFFICE USE -
L,AND USE: \ \ \; 1
\\{ & I
CO NSTR. TYPE: IV
,
To re<htest an Inspection, you must call 726-3769. This Is a24 hour re'6ordlng. All Inspections requested before 7:00 a.m, will be
made.tfi,~ same working day, Inspectlons requested after 7:00 a.m. will be made the fOllowing work day,
~ ~, \ REQUIRED INSPECTIONS .
i',... 4J Temp~)ary Electric ~ ~~~e~~ Mechanical - Prior to
; .~\."
m Site I'n~pectlon '- To be made . r'll RoughEle~trlcal ...,. Prl6r to '
Lpd after e>:cavatlon, but prior to '--f! cover.
setllngiforms. .
. 1 ...
O UndersJlab Plumblng/Electrlcal/.
. MechEmlcal. - Prior to cover.
t ..
rvJ Footl:hg - After trenches are
L-f<J excavated; .'
I ..,.
( " ,
m Ma;~onry - Steel ,location, bond
~ be,;ams, grouting. ,
# OF UNITS:
HEAT SOURCE:
S
RANG E:
. .
f\7I Electrical Service -- Must be
7 approved to obtain permanent
electrical power.
rvl Fireplace - Prior to facing
~ materials and framing Insp,
EfJ Framing - Prior to cover,
m Wail/Ceiling Insulation - Prior to
r cover.. .
Lf1 Drywall - Prior to taping.
o Wood Stove - After Installation.
o Insert - After fireplace apprOVl!l1
and Installation of unit.
r\1l Curbcut & Approach -'After
~ forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
o Fence. - When completed,
CfJ ,Street Trees - When all req,ulred
trees are planted: . I.
. -. -, .-. .
...?"
FLOOD PLAIN: '
'tONING CODE: L-D.e...J
#. OF BDRMS: ~ _
SECONDARY HEAT:t='t-J
SQUARE FOO;AGE: s::fl35.. c:;
, -
r11 Final Plumbing - When all
TPI~mblng w()rk Is complete,
rYl Final Electrical .,- When all
'{ electrical work Is complete.
f'llFlnal Mechanical ~ When all
T mechanical work Is complete,
rvJ Final Building - When all
~ required Inspections have been
approved and building is
. completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
. blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
. blocking, set-up. and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Install~9.
"";"
Lot faces
tJ
Lot sq. ftg.
Lot coverage
Topography
Total height ~
(" r=-.rr )
I..
BUILDING PERMIT
sa. FT.
ITEM
Main
/779
~?&,
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
PLUMBING PERMIT
ITEM
Lot Typ\
X Interior
'I('f.'\! .. '(' "i J., .,~'j:~~.,,: 'i'ii '~r'
. ":' ') I' :i}:"j~t,~,
Setbacks '
HSE GAR ACe'
~ .~ ' ;'~~' :,;r'::,
;l .,j.,
Corner
h~L.
, " .1.
N
Is
\W
IE
/O~/tl-
i..\ ~s.
~I ?~p~ed By:
~~~~ lj:~ ~\~
(A) 'i)()..CI1. PI~~ Reviewed By
SYSTEMS DEVELOPMENT CHARGE (SDC)
12 -1~1. ';-/
Panhandle
-*
Cul-de-sac
X $/so. FT,
Si6, '<,0
VALUE
'1 '7 <j 8"'J
" ~ /2/
(B)
FEE
Fixtures
Residential Bath(s) NO 3
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
l ~~, C:~
~~ ~~.,w.1J\
(C)
t ~~, S.s;?
c ,,~
\.. (%
f;. c!fI
'--olf.
Dryer Vent
Wood Stove/Insert/ Fireplace Unit
NO '-t
~,~
loot ~
l~.~
\ S. Cr\)
3. qJ,a""
Mechanical Permit
Issuance
State Surcharge
Total Permit
~ ~ ~w.t",-
(D)
"to.CO
\O.su..
.9...~
\,~
C" "? 1~
.... 1, 'r.~ ~
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
J.tS
:\~
II
ft
Curbcut
Demolition
State Surcharge
Total Miscellaneous Permits
1 ~,1S..
l~.~
~l.~
(E)
~,':I~'
TOTAL AMOUNT DUE (excluding electrjmtTl~~
(A, B, C, D, and E Combined) 32tG~,?1
I
IS THEPROPOSED WORK.tN THE_
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City. of Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee: 29~ <:;; /
,'YJ~/9,~
/<~7J
~~-
-'f"'" " v- ~
Date Paid:
Receipt Number'
~:~~
Systems Development Charge is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
~+- T: t~1000
, ~\\MlL-Dn,to )',
,//~ :L
~11J\ ^~rt Q_.J
~-K~Ct ~~~.t;, U~~~\A.t I
u~~t- ,- ~"
\)
J
!
By signature, I state and agree, that I have care,'ully examined
the completed application and do hereby cl~rtlfy that all
Informatlon hereon is true and correct, and I flJrther certify
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield, an d the Laws
of the State of Oregon pertaining to the work Ijescrlbed
herein, and that NO OCCUPANCY will be mad.~ of any
structure without permission of the Building Safety Division,
\
I further certify that only contractors and employees\ who
are In compliance with ORS 701.055 will be used on tf\'J~
project. '"
I further agree to ensure that all required Inspections are
requested at the proper time, that each address Is readable
from the street, that the permit card Is located at the front
of the property, and the approved set of plans will remain
on the site at all times during construction.
SI~ure
Date
VALIDATION:
RECEIPT NUMBER /~& G
DATE PAID '7(9'/5'~
~ ' - Q;;) Po- 3 7't
AMOUNT RECEIVED . ~"'-,;---_._~ c 0C,2,
~./f
4/-/( ~ -VI
\
RECEIVED BY
/
.H NO. L4/tJ U
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
ATIACHMENT B1
NAME OR COMPANY:
LOCATION: ,),;..1
DEVELOPMENT TYPE:
BUILDING SIZE:
1. STORM ORATNAl1E
IMPERVIOUS SQ. FT.
I2rA \[~~
/. .... .
~ ?-/.
Cj~/
I~OT SIZE
SQ. Ft.
23"3/
X $0.209. PER SQ'. FT. $ S'l/, t; 8""
2. ~ANITARY SFWFR-CITY
NO. OF PFU'S 2.3.
(See Reverse)
3. TRANSPORTATION
X $43.26 PER PFU
$ q r 4. f 7
NO OF UNITS, X TRIP RATE X COST PER TRIP
/ X j,cJ/ 'X $436.19
x
X
X $436.19
X $436.19
$' 4.f(),SS-
$
$
SUBTOTAL (ADD' ITEMS 1.2. & 3} $ ~o2 r.2-/
4. SANTTARY SEWFR-MW~
. NO. OF PFU'S 23 x $17.19 PER PFU + $10 MWMC ADMIN.FEE $ 46S".3 r
(Use PFU Total From Item 2 Pbove)
-' '...~
$ 'sl. 70
$ J S-:S. ~ .,.
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
... ' ,...IQIM -MWMr. SOC:.
SUBTOTAL (ADD ITEMS 1.2.3 & 4)
$ 23 80. ~ ~
5. ~~I~.ISIATTVF FFES
~ . . - ...
BASE-CHARGE (SUBTOTAL ABOVE) X .05
-it: /,J) ; '::"~~t~:';-;;~r~
/ Mar~ ~ornig. P. r. )
SD( COordinator V
$ //r:()3
. _. . I.. _ ~i. . .
. . TOTAl SQC
$:z.f'l?l/
B2 . SDC .
. . . ... ..... . .:,,',,", ....
~,
--
~'-.....
FIXTURE UNrf CALCULtV.1t>N TABLE: Number'of New FixtureS X Unit Equivalent = Fixture Units
(NOTE: For remodels, calculate pnly the MEI additional fixtures)
NUMBER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EOUIV ALENT UNITS
'-.,
I
2
1
2
3
6
2
6
6
1
3
2
l1Head
2
2
,
6
4 j-.
4-
Bathtub. .'....................... ........... ....................................
Drinking Fountain...... ........ .......................................
Floor Drain.............................. ......... ...... ...................
Interceptors For Grease/Oil/Solids/Etc.......:..........
Interceptors For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher.............. .............. .~.....
Clotheswasner - ~_ Or More.....................................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For Refrigerator/Water Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall...................... ............. ..............
Shower, Gang................... ............:..........................
Sink: Bar, Commercial, Residential Kitchen........................
Urinal, Stall/Wall..:....................................................
Wash Basin/Lavatory, Single........................ ..........
Toilet, Public Installation........................................
Toilet, Private.......................................................
Miscellaneous:
2..
:t..
z.
3
~
?
1:2.
..-,
,
TOTAL FIXTURE UNITS
=
2-~
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
caiculate credits separ'ates.
Year
Annexed
Rate per $1,000
Assessed Value
Year,
Annexed.
Rate per $1 ,000
Assessed Value
1979 or before
1980
1981
1982
1983
',1984 '
1985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
1985
1986
1987
1988
1989
1990
1991
1993
$2.46
, 2.14
1.77
1.37
0.97
0.61
0.44
0.15
"
Improvement (if after annexation date)
" ;I(
,. '. J,46 X $. /5: OVD
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
=
.5"/, ?o
Credit: for 'Parcel or land Only If Applicable
= ------
CREDIT TOTAL = $ S-/, 90
;* UNKh'oWN ANNe-A'DATf
,)
Bu I,.A ).oT Or T#IS 4~eA
WAs. ,Ptflo,e TO 1'1'11.
. - -0.
,t._.
f\'
~e YY}ll~!!!~!~!!~
OA\fV1t.
Job No. .=:nu,.
\
SYSTEMS DEVELOPMENT CHARGE
"' WORKSHEET
NAME:~ct". \\)\\o\L ..
ADDRFSS\J \~ S ~I\D~ftL
LOCATION OF IllROPOSED BUIL~R S9\E: f\...." P\\ 0... ,J "
Street Address if Known: \ Y')~ ~ -\ .( ID1WJL...;
=
TaxLotNumber: \~~ (_) \\(X)
. PHONE: 1 ~ \:)Ct-
STATE: ~IP ~
PlattNaml~
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the back,)
A. Single Family - Detached
l Single Family home
NO OF UNITS l
B. Sinl!le Family - Attached
NO OF UNITS
C. Multi-Family Aoartment
NOOF UNITS
D. Manufactured Home Park
NO OF UNITS
Manufactured home not in a park
$ 4\)).LD
X $400 PER UNIT .5=.
X $370 PER UNIT =
-$
X $277 PER UNIT =
$
X $280 PER UNIT =
$
WPRD SDC
$ {t~~
$ff
$ 4DD.oU
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approyal. See SOC Credit Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Creditl
c~~~J)
City of Springfiel~~i
r/5'
Date
/;Y